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1013469279
NIKOLE RAE ORTA
ST PETERSBURG, FL
NPI
1013469279
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Former Name
NIKOLE RAE BROOM-SMITH
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: FL 9327079)
Enumeration Date
2016-11-03
Last Update Date
2019-10-04
Business Address
NIKOLE RAE ORTA ARNP
1344 22ND ST S
ST PETERSBURG, FL 33712-2744
Phone number: 727-824-8181
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Mailing Address
NIKOLE RAE ORTA ARNP
PO BOX 25317
TAMPA, FL 33622-5317
Phone number: 813-286-0033
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